TAMPA — Addicts rolled in from Ohio, California and New York, while homeless recruits posed as needy patients. In seven months, orders for 2.4 million pain pills flew out of a Dale Mabry Highway clinic, authorities say.

The Tampa Police Department went public Thursday with details of a months-long investigation into 1st Medical Group, an extensive probe that brought the arrests Wednesday of the clinic's married co-owners and a physician, Dr. Kimberly Daffern.

All three were charged with racketeering, trafficking in a controlled substance and conspiracy to traffic in a controlled substance.

More charges could follow. At least five patients of 1st Medical Group died of overdoses, police said, declining to name them. If the deaths are linked to pills unnecessarily prescribed at the clinic, manslaughter charges could be added, police said.

Daffern posted $75,000 bail and was released Thursday night. The clinic's owners remained in the Hillsborough County Jail. Their attorney could not be reached.

Police raided the business at 2314 N Dale Mabry Highway in July, seizing hundreds of medical records dating to January.

"What they found is a disgrace to the medical profession," police Chief Jane Castor said.

From January to July, the clinic had prescribed pain pills to about 9,000 people, police say, including oxycodone that had a street value of $24 million to $60 million.

Cash was everywhere. In the Odessa home of the clinic owners, Jorge Gonzalez Betancourt and Michele Gonzalez, investigators found $132,584 in a suitcase. They found $5,050 in the clinic's safe and $82,610 in the trunk of Betancourt's BMW.

Two physicians who reviewed 107 randomly selected patient files said that 92 percent of those patients didn't need the pills they were prescribed.

Six unnamed informers, including former patients, helped Tampa police understand how the operation worked.

In 2009, Betancourt approached someone with whom he had conducted a previous money laundering scheme, the lead investigator stated in an affidavit filed in Hillsborough Circuit Court.

Betancourt said he needed help setting up the clinic and told his contact there was money to be made in the pain management business — but it would have to be done quickly because of pending regulations.

The clinic opened in mid 2009, police say.

In June of this year, another informant heard Betancourt, 50, yelling at patients for loitering outside.

The clinic owner complained that one of his biggest problems was keeping a low profile, the affidavit states. A different Tampa pain clinic had been busted after long lines outside drew police attention.

Several patients who later became police sources say they were told to leave after paying $300 in cash. Office staff would call them on cell phones when a doctor was available. Some waited three days, police say.

During the July 26 raid, a detective interviewed Dr. Daffern, 44, of Valrico. She said she had been working at the clinic since February or March and made $2,000 a day in cash, paid by Betancourt.

The clinic was popular with out-of-state patients.

One, Christopher Starr of Columbus, Ohio, had been coming since spring. After his first visit, in March, he began recruiting others to join him on the trip south, police say. Before long, the number of patients from Columbus spiked to more than 200 a month, records show.

Police say Starr, 26, even shuttled some customers down in a van. They would stop at several clinics, including 1st Medical Group, where Starr would pay for patient visits and reward them with money or pills, police say.

On July 30, Tampa police stopped Starr because he was driving a van without a license plate.

In the van, police found 1,250 tablets of oxycodone, 330 tablets of Xanax and 360 tablets of muscle relaxants, along with more than 20 unfilled prescriptions, the affidavit states.

Later, police interviewed Starr's passengers. One didn't remember the visit well, noting that oxycodone use had clouded recollection, court records state. Another recalled going to the clinic, paying money and then waiting a day to see a doctor.

Starr was arrested and charged with trafficking in illegal drugs and conspiracy to traffic in illegal drugs. Because he was found with more than 28 grams, both are first-degree felonies. He remains in the Orient Road Jail without bail.

Another informant told investigators he collected names of homeless people and gave them to clinic employees so the identities could be used for prescriptions.

Tampa police Lt. Kenny Morman, who led the investigation, said police are working closely with the Hillsborough State Attorney's Office and are confident that the clinic's main players will be held responsible.

Two more arrests are expected, with warrants outstanding for office manager Maureen Altman and employee William Pernas.

Daffern was not the clinic's only doctor. Morman would not say whether the others are suspected of wrongdoing.

In September, Hillsborough state attorneys prosecuted a Seffner doctor who was accused of unnecessarily prescribing pain pills to undercover detectives. The case ended in mistrial when the jury couldn't agree on a verdict. Prosecutors declined to retry it.

Morman believes prosecutors will have better luck with this case.

"This was not an isolated incident. It was a pattern," he said. "And we conducted an exhausting review."

Jessica Vander Velde can be reached at jvandervelde@sptimes.com or (813) 226-3433.